| NPI | 1538652870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: PA MD481395) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT215410) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2023-07-19 |